Tissue ingrowth and bowel adhesion formation in an animal comparative study: polypropylene versus Proceed versus Parietex Composite
Tissue ingrowth and bowel adhesion formation in an animal comparative study: polypropylene versus Proceed versus Parietex Composite
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DOI：
10.1007/s00464-006-9157-9
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发表时间：
2007-04-01
影响因子：
3.1
通讯作者：
Fowler, D. L.
中科院分区：
文献类型：
--
作者：
Jacob, B. P.;Hogle, N. J.;Fowler, D. L.
背景资料：腹腔镜腹壁疝修补术的最佳假体应结合联合收割机出色的壁表面组织长入和最小的内脏表面损伤。目前，很少有数据是从随机试验比较市售prosthes.Methods：在猪模型设计煽动adhesions，3个10 × 15厘米的网片（Proceed，Parietex复合材料[PCO]，聚丙烯[PPM]）随机定位在每10只动物使用缝线和钉固定腹膜内。存活28天后，对每种类型补片的收缩量、内脏粘连的面积和剥离强度、峰值剥离强度、将补片与腹壁分离所需的工作量以及代表组织长入率的系数取平均值，然后与其他假体的平均值进行比较。结果：Proceed的收缩率（99.6 cm 2）大于PCO（105.8 cm 2）和PPM（112 cm 2），但差异无统计学意义。PCO的平均粘连面积（11%）显著小于Proceed（48%; p < 0.008）或PPM（46%; p < 0.008）。PCO（5.9 N）的粘附剥离强度显著低于Proceed（12.1 N; p < 0.02）或PPM（12.9 N; p < 0.02）。根据I至5的膜-密等级，PCO（1.7）的粘连比PPM（2.9）或Proceed（3.7）更膜（p < 0.007）。PCO（17.2 N）与腹壁的峰值剥离强度显著高于Proceed（10.7 N）或PPM（10 N; p < 0.002）。每个假体的组织学表现出neoperitoneurn只有PCO.Conclusions：在这项动物研究中，在28天收缩较小，更少，更少的致密腹壁粘连和组织向内生长，PCO上级Proceed和PPM在所有类别。此外，PCO证明了腹腔镜腹壁疝修补术最佳假体所需的所有有利质量，包括新腹膜的快速形成。
Background: The optimal prosthesis for laparoscopic ventral hernia repair would combine excellent parietal surface tissue ingrowth with minimal visceral surface adhesiveness. Currently, few data are available from randomized trials comparing the commercially available prostheses.Methods: In a pig model designed to incite adhesions, three 10 x 15-cm pieces of mesh (Proceed, Parietex Composite [PCO], and polypropylene [PPM]) were randomly positioned intraperitoneally in each of 10 animals using sutures and tack fixation. After a 28-day survival, the amount of shrinkage, the area and peel strength of visceral adhesions, the peak peel strength, the work required to separate mesh from the abdominal wall, and a coefficient representing the adhesiveness of tissue ingrowth were averaged for each type of mesh and then compared with the averages for the other prostheses. The histologic appearance of each prosthesis was documented.Results: Proceed had more shrinkage (99.6 cm(2)) than PCO (105.8 cm(2)) or PPM (112 cm(2)), although the difference was not statistically significant. The mean area of adhesions to PCO (11%) was significantly less than for Proceed (48%; p < 0.008) or PPM (46%; p < 0.008). Adhesion peel strength was significantly less for PCO (5.9 N) than for Proceed (12.1 N; p < 0.02) or PPM (12.9 N; p < 0.02). According to a filmy-to-dense scale of I to 5, adhesions were more filmy with PCO (1.7) than with PPM (2.9) or Proceed (3.7) (p < 0.007). Peak peel strength from the abdominal wall was significantly higher for PCO (17.2 N) than for Proceed (10.7 N) or PPM (10 N; p < 0.002). The histology of each prosthesis showed a neoperitoneurn only with PCO.Conclusions: With less shrinkage, fewer and less dense abdominal wall adherence and tissue ingrowth at 28 days in this animal study, PCO was superior to both Proceed and PPM in all categories. Furthermore, PCO demonstrated all the favorable qualities needed in an optimal prosthesis for laparoscopic ventral hernia repair, including the rapid development of a neoperitoneum.